Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Veterans Affairs Health System Enrollment and Health Care Utilization After the Affordable Care Act: Initial Insights.

Silva A, Tarlov E, French DD, Huo Z, Martinez RN, Stroupe KT. Veterans Affairs Health System Enrollment and Health Care Utilization After the Affordable Care Act: Initial Insights. Military medicine. 2016 May 1; 181(5):469-75.

Related HSR&D Project(s)

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


The Affordable Care Act (ACA) was signed into law in 2010 and its individual mandate and expanded health care coverage options were implemented in 2014. These provisions may affect Veterans Affairs (VA) enrollment and health care utilization. Using data from two VA regional networks, we examined recent patterns in the number of new VA enrollees and their primary care use. Trends were assessed by enrollment priority group (based on the veteran's severity of service-connected disabilities, exposures, and income level) and a state's Medicaid expansion status. Compared to the same time period in the previous year, the number of new enrollees from low-income priority groups was higher during the open enrollment period and the increase was sharper in Medicaid non-expansion states (25-42%) than in expansion states (20-32%). In addition, low-income patients with a copay requirement who enrolled in the VA during the ACA open enrollment had a lower average number of primary care visits than counterparts who had enrolled in prior time periods (1.73 versus 1.87, p < 0.0001). Although this study is an initial step, more research is required to better understand veterans' decision making and behavior in regard to health care coverage through the ACA and related impacts on VA and non-VA health care utilization and care coordination.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.